Individual
BARBARA I MIKITIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1045 BREEZEWOOD DR, CANONSBURG, PA 15317-8557
(724) 344-9724
Mailing address
1045 BREEZEWOOD DR, CANONSBURG, PA 15317-8557
(724) 745-5655
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS003456L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100949442
—
PA
Enumeration date
01/28/2006
Last updated
02/02/2015
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